Healthcare Provider Details
I. General information
NPI: 1780003780
Provider Name (Legal Business Name): JOSEPH STAPLEY REDMAN M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/08/2014
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5171 S COTTONWOOD ST
MURRAY UT
84107-5704
US
IV. Provider business mailing address
PO BOX 27128
SALT LAKE CITY UT
84127-0128
US
V. Phone/Fax
- Phone: 801-507-3380
- Fax: 801-507-3738
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0008X |
| Taxonomy | Hepatology Physician |
| License Number | 11818913-1205 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RT0003X |
| Taxonomy | Transplant Hepatology Physician |
| License Number | 11818913-1205 |
| License Number State | UT |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | 11818913-1205 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: